Human Rights Watch, London, UK.
Human Rights Watch, New York, USA.
J Int AIDS Soc. 2011 Feb 11;14:8. doi: 10.1186/1758-2652-14-8.
Although HIV and tuberculosis (TB) prevalence are high in prisons throughout sub-Saharan Africa, little research has been conducted on factors related to prevention, testing and treatment services.
To better understand the relationship between prison conditions, the criminal justice system, and HIV and TB in Zambian prisons, we conducted a mixed-method study, including: facility assessments and in-depth interviews with 246 prisoners and 30 prison officers at six Zambian prisons; a review of Zambian legislation and policy governing prisons and the criminal justice system; and 46 key informant interviews with government and non-governmental organization officials and representatives of international agencies and donors.
The facility assessments, in-depth interviews and key informant interviews found serious barriers to HIV and TB prevention and treatment, and extended pre-trial detention that contributed to overcrowded conditions. Disparities both between prisons and among different categories of prisoners within prisons were noted, with juveniles, women, pre-trial detainees and immigration detainees significantly less likely to access health services.
Current conditions and the lack of available medical care in Zambia's prisons violate human rights protections and threaten prisoners' health. In order to protect the health of prisoners, prison-based health services, linkages to community-based health care, general prison conditions and failures of the criminal justice system that exacerbate overcrowding must be immediately improved. International donors should work with the Zambian government to support prison and justice system reform and ensure that their provision of funding in such areas as health services respect human rights standards, including non-discrimination. Human rights protections against torture and cruel, inhuman or degrading treatment, and criminal justice system rights, are essential to curbing the spread of HIV and TB in Zambian prisons, and to achieving broader goals to reduce HIV and TB in Zambia.
尽管撒哈拉以南非洲的监狱中艾滋病毒和结核病（TB）的患病率很高，但针对与预防、检测和治疗服务相关的因素，开展的研究却很少。
为了更好地了解赞比亚监狱中的监狱条件、刑事司法系统与艾滋病毒和结核病之间的关系，我们开展了一项混合方法研究，包括：对赞比亚六所监狱的 246 名囚犯和 30 名狱警进行设施评估和深入访谈；审查了赞比亚关于监狱和刑事司法系统的立法和政策；并对政府、非政府组织官员以及国际机构和捐助者的代表进行了 46 次关键知情者访谈。
设施评估、深入访谈和关键知情者访谈发现，艾滋病毒和结核病的预防和治疗存在严重障碍，审前拘留时间延长导致过度拥挤。监狱之间以及监狱内不同类别的囚犯之间存在明显差异，未成年人、妇女、审前被拘留者和移民被拘留者获得卫生服务的机会明显减少。
赞比亚监狱目前的状况以及缺乏医疗服务，侵犯了人权保护，威胁着囚犯的健康。为了保护囚犯的健康，必须立即改善监狱内的医疗服务、与社区医疗保健的联系、一般监狱条件和加剧过度拥挤的刑事司法系统失灵。国际捐助者应与赞比亚政府合作，支持监狱和司法系统改革，并确保他们在卫生服务等领域提供资金时，尊重人权标准，包括不歧视。保护囚犯免受酷刑和残忍、不人道或有辱人格的待遇以及刑事司法系统权利，对于遏制艾滋病毒和结核病在赞比亚监狱中的传播以及实现更广泛的减少艾滋病毒和结核病的目标至关重要。
